Citation Nr: 21032114 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 16-03 975 DATE: May 25, 2021 ORDER Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for hypertension is denied. Entitlement to service connection for a low back disability is denied. Entitlement to service connection for a left knee disability, to include as secondary to a low back disability is denied. Entitlement to service connection for obstructive sleep apnea is denied. Entitlement to service connection for genital herpes is denied. Entitlement to service connection for hypertriglyceridemia is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against a finding that bilateral hearing loss was caused by or incurred in service. 2. The preponderance of the evidence is against a finding that hypertension had its onset in, or was otherwise caused by, an eligible period of service. 3. The preponderance of the evidence is against a finding that the Veteran's low back disability was caused by or incurred in service. 4. The preponderance of the evidence is against a finding that the Veteran's left knee disability was caused by or incurred in service, to include as secondary to a service-connected disability. 5. The preponderance of the evidence is against a finding that obstructive sleep apnea was caused by or incurred in service. 6. The preponderance of the evidence is against a finding that genital herpes was caused by or incurred in service. 7. Hypertriglyceridemia is a laboratory finding and not a chronic disability for which disability benefits may be awarded. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 2. The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 3. The criteria for entitlement to service connection for a low back disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 4. The criteria for entitlement to service connection for a left knee disability, to include as secondary to a low back disability have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 5. The criteria for entitlement to service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.310. 6. The criteria for entitlement to service connection for genital herpes have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.310. 7. The criteria for entitlement to service connection for hypertriglyceridemia have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from September 1979 to February 1984. This case comes on appeal of a February 2012 rating decision. The Veteran testified before the Board at an August 2019 travel board hearing. These matters were previously before the Board in August 2020, at which time the Board remanded the claims for further development. At the outset, the Board notes that the Veteran had an additional period of service from February 1984 to July 1987, from which he was discharged under other than honorable conditions. In May 2011, VA informed the Veteran that, due to the circumstances of his discharge, he was not eligible for VA benefits for disabilities caused by or incurred during this second period of service. The Veteran did not disagree with this determination. Moreover, the Veteran's service treatment records are not available for his first period of service. Service treatment records from the second period of service include notations that these initial service treatment records were lost. VA performed a search for the records subsequent to the Veteran's filing of this claim. In June 2011, VA determined that the records were unavailable and informed the Veteran of this fact in the February 2012 rating decision. When service records are incomplete, the Board has a heightened obligation to explain its findings and conclusions and carefully consider the benefit-of-the-doubt rule. See Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). However, the case law does not lower the legal standard for proving a claim of service connection, but rather increases the Board's obligation to evaluate and discuss in its decision all of the evidence that may be favorable to the Veteran. See Russo v. Brown, 9 Vet. App. 46 (1996). Moreover, there is no presumption, either in favor of the claimant or against VA, arising from missing records. See Cromer v. Nicholson, 19 Vet. App. 215, 217-18 (2005) (wherein the Court declined to apply an "adverse presumption" where records have been lost or destroyed while in government control which would have required VA to disprove a claimant's allegation of injury or disease). Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303, 3.304. Service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Walker v. Shinseki, 701 F.3d 1331 (Fed. Cir. 2013). For chronic diseases listed in 38 C.F.R. § 3.309(a), including arthritis and organic diseases of the nervous system, the linkage element of service connection may also be established by demonstrating continuity of symptoms since service. 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331 (Fed.Cir.2013). 38 C.F.R. § 3.307(a)(3) provides for presumptive service connection for chronic diseases that become manifest to a degree of 10 percent or more within 1 year from the date of separation from service. Sensorineural hearing loss may be considered an organic disease of the nervous system for the purposes of 38 C.F.R. § 3.309(a). Notwithstanding the lack of evidence of disease or injury during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disability was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for bilateral hearing loss The Veteran underwent a February 2021 VA hearing loss examination that demonstrated the presence of bilateral hearing loss for VA purposes. Therefore, the requirement of a current disability is satisfied. At issue is whether hearing loss was caused by or incurred in service. The Veteran testified at his Board hearing that he was an aviation mechanic during his first period of service and assisted with testing engines. Although he wore hearing protection during this time, he stated that he noticed diminishing hearing during service. Although most of the Veteran's service treatment records from his first period of service are missing, the record does contain the Veteran's audiogram from his September 1979 enlistment examination. That audiogram demonstrates hearing thresholds of: HERTZ 500 1000 2000 3000 4000 RIGHT 20 20 25 25 10 LEFT 20 20 30 15 0 At the time of the Veteran's discharge from his second, ineligible, period of service, a separation audiogram demonstrates hearing thresholds of: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 20 5 20 LEFT 20 20 25 10 5 Thus, although service connection is not available for disabilities caused by or incurred during that second period of service, treatment records are useful for demonstrating the course of the Veteran's health at that time. As was noted above, the Veteran underwent a VA examination in February 2021. Through the Board's August 2020 remand instructions, the examiner was asked to opine on whether the Veteran's hearing loss was caused by or incurred in service. The examiner was specifically asked to consider the comparison of the enlistment and separation audiometric data. Notably, at the time of the February 2021 examination, the examiner was not aware of the presence of the Veteran's enlistment audiogram and provided only a speculative opinion. However, the agency of original jurisdiction (AOJ) reiterated to the examiner that the enlistment audiogram was available and requested an addendum opinion based on an accurate understanding of the Veteran's medical history. After reviewing the Veteran's enlistment audiogram, the examiner opined that it was less likely than not that the Veteran's bilateral hearing loss was caused by or incurred in service. By way of rationale, the examiner explained that a comparison of the separation audio evaluation to the enlistment audiogram indicated that there was not a significant threshold shift over the Veteran's entire period of service. In other words, the evaluations showed that at the time the Veteran was discharged from his second period of service, his hearing abilities had not significantly changed. The examiner went on to explain that, although noise exposure in service was conceded, the evidence showed that there was no noise injury while in service. The examiner clarified that not everyone who is exposed to noise will suffer noise injury, and that delayed onset hearing loss due to previous noise exposure was unlikely to occur. Therefore, according to the examiner, if the evidence shows that there have been no significant threshold shifts beyond normal measurement variability during service, any hearing loss occurring following service is less likely as not caused by a result of noise exposure while in service. The examiner noted that many factors can contribute to hearing loss following service such as recreational, occupational, and environmental noise exposure, aging, disease, medications, hereditary factors, and smoking. However, in the absence of objective audiometric evidence of noise injury while in service, the notion that the Veteran suffered some latent undiagnosed noise injury while in service would contradict the objective evidence of record. The examiner noted that she based her opinion, in part, on a 2005/2006 study by the Institute of Medicine (IOM). The examiner explained that the IOM study stated that "There is not sufficient evidence from longitudinal studies in laboratory animals or humans to determine whether permanent noise-induced hearing loss can develop much later in one's lifetime, long after the cessation of that noise exposure. Although the definitive studies to address this issue have not been performed, based on the anatomical and physiological data available on the recovery process following noise exposure, it is unlikely that such delayed effects occur." The examiner then acknowledged that the authors of more recent studies had questioned the conclusions of the IOM report but, in doing so, had misquoted the report. The examiner explained that the IOM study looked at animal studies and found no difference in hearing sensitivity over time between exposed and non-exposed animals. Here, the Board notes that the United States Court of Appeals for Veterans Claims ruled in McCray v. Wilkie, 31 Vet. App. 243 (2019), that when determining the adequacy and probative value of a medical opinion, the Board must consider whether the medical text evidence that the medical opinion relies on contains qualifying or contradictory aspects. The Court explained that if the Board finds that a medical text that serves as the basis for a medical opinion contains apparent qualifiers or contradictions, or if the veteran raises the issue or it is reasonably raised from review of the evidence of record, the Board must address that issue and explain whether those aspects of the medical text diminish the probative value of the medical opinion evidence or render the opinion inadequate, and if not, why not. The Court specifically identified the IOM study as containing apparent qualifiers or contradictions. In this case, the Board agrees with the examiner's clarification regarding the IOM report. As was discussed above, although the report stated that "definitive studies to address this issue have not been performed," based on the evidence available, the report stated that it was "unlikely" that delayed hearing loss effects occur. This statement tends to show that the limitation was considered, but the IOM was confident in the available data (anatomical and physiological) to make a conclusion utilizing a strongly worded term ("unlikely"). In citing to the IOM report, the February 2021 examiner relied on medical literature that indicated further testing could be done on the matter, but that the available evidence was against a finding of delayed onset hearing loss. The absence of definitive scientific evidence does not mean that a delayed onset of hearing loss following acoustic trauma is probable, or even just as likely as not. Thus, the IOM report is not necessarily given overwhelming probative value, but is still given significant probative value. The report is still an informed medical conclusion based on data about hearing loss and the Board finds that it is of significant enough probative value to be instructive to the examiner. Moreover, the Court in McCray referenced "a medical text's qualifying or contradictory aspects" as one factor on a non-exhaustive list that is relevant to the Board's evaluation of the probative value and adequacy of a medical opinion. McCray, 31 Vet. App. at 257. Here, the examiner identified a number of additional factors that were more likely to contribute to the Veteran's hearing loss decades after service. Therefore, the VA examiner's reliance on the IOM study was not misplaced, and given that the examiner also considered the Veteran's prior medical history and lay statements and provided a sufficient rationale for the Board to evaluate the claim, the Board gives much probative weight to the VA examiner's opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). In the absence of any competent medical evidence to the contrary, the preponderance of the evidence is against a finding that the Veteran's current hearing loss disability was caused by or incurred in service. Regarding sensorineural hearing loss as a chronic disease, the evidence does not show the presence of a hearing loss disability manifesting to 10 percent compensability within one year of service. The evidence of record also fails to show a continuity of symptoms since service. The Board acknowledges the Veteran's statements that he began experiencing diminished hearing acuity during service; however, as a layperson, the Veteran is not competent to state his current disability in fact existed during service. Indeed, given the presence of the separation audiogram from the Veteran's second period of service showing no hearing loss disability, coupled with the examiner's analysis above, the more probative evidence of record suggests that the Veteran's current hearing loss disability did not have in-service onset, with a continuity of symptoms since service. Accordingly, as the preponderance of the evidence is against this finding, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for hypertension VA treatment records demonstrate that the Veteran was first diagnosed with hypertension in June 2009. Therefore, the requirement of a current disability is satisfied. At issue is whether hypertension was caused by or incurred in service. The Veteran contends that he was first diagnosed with hypertension during his first period of service. Moreover, he contends that the stressful conditions of his service contributed to his current disability. Although service treatment records from the Veteran's first period of service are unavailable, there are some available records that help piece together the Veteran's overall health picture during that time. For example, the record contains a January 1983 dental health questionnaire on which the Veteran checked "No" to the question of whether he had high blood pressure. At a February 1985 dental examination, the Veteran's blood pressure was 148/80 and at a February 1986 dental examination, his blood pressure was 140/94. At this second examination, the Veteran once again checked "No" when asked if he had high blood pressure. A March 1987 treatment record noted a positive history of hypertension. At the Veteran's July 1987 separation examination, his blood pressure was 163/104 and he was told to follow up with VA for high blood pressure. The Veteran testified that he did not address his hypertension until 2009, when he was eventually found to have severe hypertension. Thus, the available records show that the Veteran denied having high blood pressure both during and after his first period of service, until at least 1986. Sometime between February 1986 and March 1987i.e., during the Veteran's ineligible period of serviceit appears he began experiencing problems with blood pressure to the extent that it was considered something he should follow up with upon separation. However, this evidence suggests that the Veteran was not diagnosed with, or treated for, hypertension during his first period of service. Regarding the Veteran's theory that in-service stress caused his hypertension, the Veteran underwent a VA examination in February 2021 to allow an examiner to evaluate his symptoms and address this contention. The examiner opined that it was less likely than not that hypertension was either caused by or incurred in service. By way of rationale, the examiner explained that there were a number of risk factors that were strongly, and independently, associated with the development of hypertension. These risk factors included: age, obesity, family history, race, a reduced nephron number, high sodium diet, excessive alcohol consumption, and physical inactivity. The examiner noted that the Veteran had multiple risk factors, including age, race, obesity, and a history of excessive alcohol use. The examiner also explained that stress was not a known risk factor for the development of chronic hypertension. The examiner's opinion is well-supported by medical rationale and is therefore probative. Meanwhile, aside from the Veteran's own contentions, there is no evidence to support the theory that hypertension was caused by in-service stress. Here, the Board observes that, as a layperson, the Veteran is not competent to provide this type of etiological opinion as it requires medical expertise. Therefore, the preponderance of the competent evidence is against a finding that hypertension was caused by or incurred during an eligible period of service. As the preponderance of the evidence is against this finding, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 3. Entitlement to service connection for a low back disability Medical records, to include a February 2021 VA examination show that the Veteran has a diagnosis of degenerative joint disease and degenerative disc disease of the lumbar spine, first diagnosed in November 2010. Therefore, the requirement of a current disability is satisfied. At issue is whether the disability was caused by or incurred in service. The Veteran contends that the conditions of his sea service, to include frequent running up and down stairs of his ship, resulted in wear and tear of his back that led to his current disability. The available service treatment records from the Veteran's second period of service show that the Veteran complained of a two-week history of back pain in March 1987. The Veteran's July 1987 separation examination shows that the Veteran checked "Yes" to recurrent back pain on his report of medical history, but there was no chronic back condition noted on clinical evaluation. Post-service medical records note that the Veteran was first seen for VA treatment in June 2009. At that time, the Veteran reported having been in a severe automobile accident in 1987 after separation from service in which he fractured his neck. The Veteran reported that he had experienced left low back pains since the accident that had been worse over the prior three years. The Veteran also testified at his hearing that he had undergone back surgery through VA. VA treatment records indicate that the Veteran underwent surgery to remove a lipoma of the lower back in February 2011, however, there is no indication that this was related to a musculoskeletal condition. The Veteran underwent a VA examination in February 2021. There, the examiner opined that it was less likely than not the Veteran's current back disability was caused by or incurred in service. The examiner first observed that, based on the available service treatment records, there was no evidence of a chronic low back condition during the Veteran's eligible period of service. Regarding the Veteran's theory that his back disability was caused by the conditions of his service, the examiner observed that it was much more likely that the Veteran's age and weight were the contributing factors toward his degenerative disability. Indeed, the examiner noted that medical literature showed that being overweight increases the load placed on the weight bearing joints, which increases stress, predisposes the individual to arthralgia, and could possibly hasten the breakdown of cartilage, ultimately increasing the risk for developing osteoarthritis. The examiner further reported that the Veteran's degenerative disc disease and degenerative joint disease changes of the lumbar spine were consistent with those expected based on combination of the Veteran's age and body mass index. The examiner's opinion is well-supported by medical rationale and is therefore probative. Meanwhile, aside from the Veteran's own contentions, there is no evidence to support the theory that his low back disability was caused by the physical nature of his service, to include running up and down stairs. Here, the Board observes that, as a layperson, the Veteran is not competent to provide this type of etiological opinion as it requires medical expertise. Regarding arthritis as a chronic disease, the Board finds that there is no evidence of a low back arthritis disability manifesting to 10 percent compensability within one year of the Veteran's eligible period of service. Indeed, given that this one year was encompassed by the Veteran's second, ineligible, period of service and that service treatment records exist for that period, the Board can say that there are no records identifying a compensable low back disability during that time. The probative evidence of record also fails to show a continuity of symptoms since his eligible service. Accordingly, as the preponderance of the evidence is against these findings, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 4. Entitlement to service connection for a left knee disability, to include as secondary to a low back disability Medical evidence demonstrates that the Veteran has diagnosed left knee degenerative joint disease, status post left knee arthroscopy, with a partial medial meniscectomy that was performed July 2012. Therefore, the requirement of a current disability is satisfied. At issue is whether the disability is causally related to service. The Board notes that the Veteran's primary contention was that the left knee disability was caused or aggravated by his low back disability. As the Board has found that service connection is not warranted for the low back disability, service connection on a secondary basis for the left knee is not warranted either. However, the Veteran also noted at his Board hearing that the conditions of his service, to include the physical routine of running up and down the stairs of the ship to report to duty, could have caused the left knee disability as well. Notably, there is no evidence of an injury to the knee in the Veteran's available service treatment records. Post-service treatment records show the Veteran complained of left knee pain in his initial VA treatment visit in June 2009. At that time, the Veteran reported that both knees were injured when he was in a severe automobile accident in 1987 but only the left knee bothered still bothered him. The Veteran has continued to have left knee symptoms since beginning VA treatment, to include the surgery noted above. The Veteran underwent a VA knee and lower leg examination in February 2021. At that time, the examiner noted the Veteran's current diagnosis. The examiner also noted the Veteran's report that he had injured his left knee on an iron rail during service in 1984. The examiner opined that it was less likely than not that the Veteran's left knee disability was caused by or incurred in service. The examiner observed that there were no records to demonstrate a left knee condition during service, whether during the Veteran's eligible period of service or otherwise. The examiner explained that it was more likely that the Veteran's left knee condition was caused by a combination of the injuries incurred during his automobile accident, as well as age and obesity. The examiner noted that, at the time of his meniscal tear, the Veteran was 50 years of age and his body mass index was 35, which falls into the obese range. The examiner stated that medical literature supported that being overweight would increase the load placed on the weight-bearing joints, which increases stress, predisposes the individual to arthralgia, and increases the risk of ostearthritis. According to the examiner, x-rays taken in 2011 demonstrated only mild bilateral degenerative joint disease. Given the mild severity of the disease at that time, as well as the Veteran's other risk factors, there was no evidence to support that the Veteran's left knee disability was due to service that was over 20 years prior to the diagnosis. The examiner's opinion is well-supported by medical rationale and is therefore probative. Meanwhile, aside from the Veteran's own contentions, there is no evidence to support the theory that his left knee disability was caused by the physical nature of his service, to include running up and down stairs. Here, the Board observes that, as a layperson, the Veteran is not competent to provide this type of etiological opinion as it requires medical expertise. Regarding arthritis as a chronic disease, the Board finds that there is no evidence of a left knee arthritis disability manifesting to 10 percent compensability within one year of the Veteran's eligible period of service. Indeed, given that this one year was encompassed by the Veteran's second, ineligible, period of service and that service treatment records exist for that period, the Board can say that there are no records identifying a compensable left knee disability during that time. The probative evidence of record also fails to show a continuity of symptoms since his eligible service. Accordingly, as the preponderance of the evidence is against these findings, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 5. Entitlement to service connection for obstructive sleep apnea The Veteran underwent a March 2011 sleep study that showed a diagnosis of obstructive sleep apnea. Therefore, the requirement of a current disability is satisfied. At issue is whether the disability was caused by or incurred in service. At his Board hearing, the Veteran testified to his belief that sleep apnea had its onset in service. In support of this theory, the Veteran noted that he was told he snored and that he would sometimes wake up during his sleep. The Veteran underwent a VA examination in February 2021. There, the examiner opined that it was less likely than not that sleep apnea was caused by or incurred in service. The examiner acknowledged that the Veteran's statements and other submitted lay statements may note the existence of snoring, however, snoring alone does not confirm a diagnosis of sleep apnea. Indeed, the examiner found that there was no evidence demonstrating that sleep apnea had an onset during the Veteran's eligible period of service. The examiner further explained that, at the time of his sleep apnea diagnosis, the Veteran had a body mass index of 35, indicating obesity. According to medical literature, the examiner stated, obesity is the primary factor for obstructive sleep apnea. The Veteran also met other predisposing factors such as male sex and an age between 40 and 65 at the time of diagnosis. Thus, given the lack of evidence of an in-service onset, and multiple risk factors at the time of diagnosis, the examiner found it was less likely than not that sleep apnea was related to service. The examiner's opinion is well-supported by medical rationale and is therefore probative. Meanwhile, aside from the Veteran's own contentions, there is no evidence to support the theory that had onset in, or was caused by, service. The Board acknowledges that the Veteran is competent to report his observations, or observations of others, that he snored during service. However, as the examiner noted, this is not the same as a sleep apnea diagnosis. Here, the Veteran, as a layperson, is not competent to diagnose sleep apnea. Accordingly, based on the foregoing, the preponderance of the evidence is against a finding that sleep apnea had its onset in, or was otherwise caused by, service. As the preponderance of the evidence is against this finding, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 6. Entitlement to service connection for genital herpes The Veteran's medical records note an ongoing diagnosis of genital herpes. Therefore, a current diagnosis is established. At issue is whether the condition was incurred in service. The Veteran contends that he contracted genital herpes while he was stationed in the Philippines. Indeed, he noted in a January 2013 statement that his service treatment records would support this contention. As has been noted throughout this decision, the Veteran's service treatment records from his first period of service are unavailable. Nevertheless, evidence from the available service treatment records does not support the Veteran's contentions. For example, in a February 1986 dental health questionnaire, the Veteran responded "no" to a history of hepatitis or venereal disease. In March 1987 treatment, the Veteran denied contact with any communicable diseases. Then, at his July 1987 separation examination and report of history, the Veteran checked "No" when asked if he had ever had a venereal disease. Thus, although the service treatment records from the Veteran's service in the Philippines are unavailable, it is reasonable to conclude that the Veteran did not contract genital herpes during his eligible period of service. Given that the Veteran himself denied having ever had a venereal disease after his eligible period of service had concluded, the evidence is against a finding that he contracted genital herpes prior to that point. The Board finds the Veteran's more recent statements regarding the onset of genital herpes to be less credible than his responses to questions in the course of medical treatment at the time of service. See Rucker v. Brown, 10 Vet. App. 67, 73 (1997) (statements made for the purposes of medical treatment may be afforded greater probative value than statements made for the purposes of seeking compensation). Accordingly, the preponderance of the evidence is against a finding that genital herpes had its onset in, or was otherwise caused by, service. As the preponderance of the evidence is against this finding, the "benefit of the doubt" rule is not applicable and the Board must deny the claim. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 7. Entitlement to service connection for hypertriglyceridemia The Veteran currently has high cholesterol, claimed as hypertriglyceridemia, which he asserts is related to service. Based on a thorough review of the record, the Board finds that the preponderance of the evidence is against service connection for high cholesterol, as this condition is not a disability for VA purposes and is not related to any other underlying disabilities. High cholesterol is also referred to as hypercholesterolemia or hyperlipidemia. Hypercholesterolemia is an "excess of cholesterol in the blood." DORLAND'S ILLUSTRATED MEDICAL DICTIONARY 887 (32nd Edition 2012). Hyperlipidemia is "a general term for elevated concentrations of any or all of the lipids in the plasma, such as hypertriglyceridemia, hypercholesterolemia, and so on." Id. at 891. Thus, hypertriglyceridemia is a specific type of hyperlipidemia, or high cholesterol. The term "disability" as used for VA purposes refers to impairment of earning capacity. See Allen v. Brown, 7 Vet. App. 439, 448 (1995). Hyperlipidemia and elevated cholesterol are laboratory findings and are not disabilities in and of themselves for which VA compensation benefits are payable. See 61 Fed. Reg. 20,440, 20,445 (May 7, 1996). In the absence of proof of a present disability there can be no valid claim." Brammer v. Brown, 3 Vet. App. 223, 225 (1992); see also Rabideau v. Derwinski, 2 Vet. App. 141, 143-44 (1992); Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). In sum, the evidence demonstrates that the Veteran is not entitled to service connection for high cholesterol. High cholesterol is a laboratory finding that manifests itself only in laboratory test results and is not a disability for which service connection can be granted. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Giaquinto, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.